What you need to know about Hepatitis A

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If you’ve been listening to the news lately, you may have heard about the Hepatitis A outbreak in Kentucky. Over 300 people have been affected in an area that comprises several counties. Other states have also seen outbreaks. The source has yet to be confirmed, but some other recent outbreaks have been linked to tainted food.

Though it’s a highly contagious viral infection, Hepatitis A can be fairly easily prevented by getting vaccines and practicing good hygiene, like washing your hands.

There are several types of hepatitis. Here is a good article from the American Academy of Pediatrics that discusses Hepatitis A infections in children. According to the article, “Hepatitis symptoms tend to be similar from one virus type to another. Many of these symptoms are flu like, such as fever, nausea, vomiting, loss of appetite, and tiredness, sometimes with pain or tenderness of the liver in the right upper abdomen. A hepatitis infection is also associated with jaundice, a yellow discoloration of the skin and a yellowish color to the whites of the eyes. This is caused by inflammation and swelling of the liver with blockage and backup of bile (bilirubin) into the blood. This backup also usually causes the urine to turn dark orange and stools light yellow or clay colored. However, many children infected with the hepatitis virus have few if any symptoms, meaning you might not even know that your child is sick. In fact, the younger the child, the more likely she is to be symptom free. For example, among children infected with hepatitis A, only about 30% younger than 6 years have symptoms, and most of them are mild. Symptoms are more common in older children with hepatitis A, and they tend to last for several weeks.”

From the same article about how the virus is transmitted to children: “Hepatitis A is contracted when a child eats food or drinks water that is contaminated with the virus or has close contact with a person who is infected with the virus. Hepatitis A is present in the stool as early as 1 to 2 weeks before a person develops the illness. The infection can be spread in child care settings when caregivers do not wash their hands after changing the diaper of an infected baby or from infant to infant because most very young infants do not wash their hands or have their hands washed for them.”

Here’s the good news: Hepatitis A vaccines work! As a matter of fact, beginning with the 2018-19 school year, Kentucky will require all students K-12 to have received two doses of the Hepatitis A vaccine.

If your child is a patient at Georgetown Pediatrics and is at least one year old, we’ve already discussed this with you.

Are you unsure if your child’s vaccinations are up-to-date for the next school year? Give our office a call and we can access your vaccinations records.

There is still time to get a flu shot, and if your children haven’t had theirs, they should

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Everyone knows someone who has had the flu this season. Many people think it’s too late to get a preventive flu shot (vaccine), because surely it has run its course in our community. Well, it isn’t too late, and the flu season isn’t over by a long shot.

We will be seeing flu cases until at least spring break. Last year we still had cases in April, so there are eight weeks of flu season left.

If your child hasn’t had a flu shot yet, now is the time. We see in our practice how effective the vaccine is for your family.

This year to date we have had 279+ cases of the flu in our practice alone. In the previous two flu seasons, the total number of cases in our practice were 234 (2016-17) and 148 (2015-16). As you can see, the numbers are higher this year, which means your family has an increased exposure.

But the vaccine helps a great deal. Of the 279 cases so far, 125 cases were of Type A flu among those who had not had the vaccine. Only 46 children who’d had the vaccine got Type A flu. There have been 80 cases of Type B among those with no vaccine, and only 28 cases of Type B in kids who’d had the flu shot.

We have given over 3,500 doses of flu vaccine this season, and we find the chances are much greater of contracting flu when patients haven’t had the shot.

Every year we notice in our practice:

Patients that get the vaccine have a milder course. According to an article by the Centers for Disease Control and Prevention (CDC), “During past seasons, approximately 80% of flu-associated deaths in children have occurred in children who were not vaccinated. Based on available data, this remains true for the 2017-2018 season, as well.”
In families where everyone is vaccinated and someone gets the flu, the entire household may not be affected
Even when the vaccine fails for one strain, it will protect against other strains. As you can see above, we are seeing plenty of both types.
Getting one strain will not protect you from the other (if you’ve had Type A already, you may still get Type B, and vice versa). So even if you’ve had the flu, you should still get the shot.
It takes two weeks for the vaccine to be protective. For infants and toddlers, it takes 2 doses of vaccine to be effective. Note: Infants and children 6 months to less than 9 years of age who received at least 2 doses of trivalent or quadrivalent influenza vaccine prior to July 1, 2017 need only 1 dose of the 2017 to 2018 seasonal influenza vaccine. The 2 doses need not have been received during the same season or consecutive seasons. All other children less than 9 years of age (including those whose vaccination status cannot be determined) should receive 2 doses separated by 4 or more weeks in order to achieve effectiveness, according to the CDC.
If you don’t remember when your infant or child had a vaccine, call our office.
Tamiflu is not a guaranteed back up plan if your family gets the flu. We are now starting to experience shortages of Tamiflu and it may not be widely available in the next few weeks. However, we still have vaccine available.

Bottom line: the flu is still prevalent, but you can help protect your family by getting everyone vaccinated.

Call us for an appointment.

Viewing the solar eclipse safely

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On Monday, August 21, a partial solar eclipse will cross our path here in Scott County. Even though we won’t experience the total eclipse (you’d have to travel a few hours south or west of here for that view), it’s still an exciting phenomenon that is a rare occurrence. It can also be very dangerous to the eyes without special ways of viewing it.

The eclipse here will be about 95% complete, with the height at around 2:30 PM, but the event begins at about 1:00 PM and ends at 3:50 or a bit later, depending on where you live. Children and teens will understandably be tempted to look at the sun during the partial eclipse. Because many of them will be on their way home from school, talk to them ahead of time and warn them of the danger to their eyes.

Looking directly at the sun, even briefly, can cause serious eye damage. The only safe way to look at the eclipse is through special sunglasses. Even extremely dark sunglasses are not safe.

Here is important information from an article by the American Academy of Ophthalmology:

Staring at the sun for even a short time without wearing the right eye protection can damage your retina permanently. It can even cause blindness, called solar retinopathy.

There is only one safe way to look directly at the sun, whether during an eclipse or not: through special-purpose solar filters. These solar filters are used in “eclipse glasses” or in hand-held solar viewers. They must meet a very specific worldwide standard known as ISO 12312-2.

Keep in mind that ordinary sunglasses, even very dark ones, or homemade filters are not safe for looking at the sun.

Steps to follow for safely watching a solar eclipse:

*Carefully look at your solar filter or eclipse glasses before using them. If you see any scratches or damage, do not use them.

*Always read and follow all directions that come with the solar filter or eclipse glasses. Help children to be sure they use handheld solar viewers and eclipse glasses correctly.

*Before looking up at the bright sun, stand still and cover your eyes with your eclipse glasses or solar viewer. After glancing at the sun, turn away and remove your filter—do not remove it while looking at the sun.

*The only time that you can look at the sun without a solar viewer is during a total eclipse. When the moon completely covers the sun’s bright face and it suddenly gets dark, you can remove your solar filter to watch this unique experience. Then, as soon as the bright sun begins to reappear very slightly, immediately use your solar viewer again to watch the remaining partial phase of the eclipse.

*Never look at the uneclipsed or partially eclipsed sun through an unfiltered camera, telescope, binoculars or other similar devices. This is important even if you are wearing eclipse glasses or holding a solar viewer at the same time. The intense solar rays coming through these devices will damage the solar filter and your eyes.

*Talk with an expert astronomer if you want to use a special solar filter with a camera, a telescope, binoculars or any other optical device.

For information about where to get the proper eyewear or handheld viewers, check out the American Astronomical Society.

Some Scott County retailers are carrying the filtered sunglasses for very reasonable prices (as low as $1.00), but you’ll want to get them before they sell out. They have cardboard or paper frames.

Please talk to your children about viewing the eclipse safely. It’s a great opportunity to discuss the movement of earth and moon, along with the thrill of science.

Be safe, and learn.

We welcome Dr. Katie Smallwood to our practice!

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Georgetown Pediatrics is once again expanding our staff so that we may better serve our patients. Dr. Katie Smallwood recently joined our practice after completing medical school and residency at the University of Kentucky. At UK she was a recipient of several awards, including the John H. Githens Award for Excellence in Pediatrics.

Having grown up in a small town in eastern Kentucky, Dr. Smallwood searched for a practice with a strong sense of community. She felt that Georgetown Pediatrics was the perfect fit as the physicians and staff are not only dedicated to providing comprehensive care to their patients and families, but are also very connected to the local community. This connection is an attribute of our practice we’re proud of, and we are excited that Dr. Smallwood appreciates those same values.

Dr. Smallwood, her husband Brett, and their dogs, Callie and Potato, love living in Georgetown and continuing to explore their new surroundings.

Call our office to schedule an appointment with our newest physician.

Our patient portal is for YOU

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You may already know about our patient portal, but do you know about all the benefits of using it?

The Georgetown Pediatrics Patient Portal is a secure way to check on your child’s health records and even download and print them for school, sports, or your home records. You don’t have to be a computer genius or internet guru to use the site. It’s now more user-friendly than ever, so if you haven’t checked it out in a while, we hope you’ll do so soon.

If you haven’t registered (or don’t remember if you have or not), make sure we have your current email address. Then go to the portal’s website, www.healthportalsite.com/georgetownpeds, to sign in. You’ll need a separate password and username for each child, so be sure to record them somewhere in a secure place.

How and why might you use the portal? Here are a few things you can do easily on your child’s portal page:

verify appointments;
view and print immunization records;
receive documentation from our office (school notes, medication forms, FMLA forms, etc.);
direct communication with your child’s physician;
refill medications;
see a list of all medications;
view lab and diagnostic results;
update personal information (address, phone number, emergency contact).

As you can see, the convenience of the patient portal is a great addition to your busy life.

Our brochure with more information is attached. Please take a few moments to look it over and start accessing your child’s medical information anytime, anywhere from your computer or smart phone.

patient portal pamphlet- BACK patient portal pamphlet- FRONT

Important EpiPen® recall information

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The FDA (Federal Drug Administration) recently issued a voluntary recall for certain lot numbers of the injectable EpiPen® and EpiPen Jr. This is due to a possible problem with the injector itself.

EpiPen® contains epinephrine, a drug used to treat severe allergic reactions. In a couple of cases outside the United States, the injector failed “due to a potential defect in a supplier component,” according to the FDA.

The affected lots were distributed between December 17, 2015 and July 1, 2016. Not all lots are affected, and you don’t need to replace any EpiPens that aren’t on this list.

If you do have an EpiPen® on this list, don’t get rid of it until you have obtained a replacement. Any time you use an EpiPen®, you should seek emergency medical help right away, especially if it did not activate.

Mylan, the company that distributes EpiPen®, has this information on its website (from the manufacturer Meridian):

If you think you may be impacted by this recall, please follow these steps:

STEP 1: Check the lot number on your carton or device to see if your EpiPen^® Auto-Injector is affected by the recall.

STEP 2: If your EpiPen^® Auto-Injector has been recalled, contact Stericycle at 877-650-3494 to obtain a voucher code for your free replacement product. Stericycle also will provide you with a pre-paid return package to ship the product back to Stericycle.

STEP 3: Visit your pharmacy with your voucher information to redeem your free replacement.

STEP 4: Send your recalled product to Stericycle. Do not return any devices affected by the recall until you have your replacement in hand.

Contact your pharmacist if you have questions, or if you’re unsure if your current EpiPen® is on the recall list.

New information about preventing peanut allergies

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An extensive study of children and peanut allergies has recently been released, and it encourages pediatricians to re-assess the recommendations that have been in place for some time. The study, called LEAP (Learning Early About Peanut Allergy), looked at children who have a severe or mild risk of developing peanut allergy and those who don’t.

Peanut allergies have been on the rise in recent years. Conventional wisdom has been that infants and toddlers should not be given peanuts or peanut products until they were older. That wisdom is now changing as a result of the LEAP study, conducted by the National Institute of Allergy and Infectious Diseases (NIAID).

The director of NIAID said in a recent press release: “We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”

So, what are the new guidelines, and what should parents do about introducing peanuts to the diets of their young children?

For babies who are considered to be at NO risk for developing a peanut allergy, parents can begin introducing peanut butter with solid foods at about six months of age. The LEAP study concludes that once peanut butter is introduced and tolerated with no allergic reaction, it should remain in the baby’s diet with some regularity.

There are different guidelines for babies and young children who are determined to be at moderate or severe risk of developing peanut allergy. How do you know whether or not your child is at risk? There are several factors that contribute to that risk, and it’s a conversation you should have with your child’s pediatrician in the office before introducing peanut butter into the diet.

Your concerns are our concerns, and we look forward to answering any questions you may have at your child’s next checkup.

Good eating habits as a way of preventing obesity and eating disorders

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Back-to-school time involves changes in just about everything: schedules, homework, sports, family time—even eating. Being rushed in the mornings makes having a decent, healthy breakfast a challenge. Families have to decide if kids will take lunch or buy the school lunch. Then comes the evening meal with people going in different directions, and often little time to prepare or eat a meal together. It’s no wonder that healthy eating and family time often take a back seat to homework, sports, and other activities.

As we all know by now, obesity among children and teens in our country is a widespread problem, and eating disorders (EDs) are also more common than before.

An article published last week on the website of the American Academy of Pediatrics (AAP) discusses how the same attitudes and habits can lead to both obesity and EDs. According to one study, dieting can actually be a precursor to obesity and EDs. Dieting “was associated with a twofold increased risk of becoming overweight and a 1.5-fold increased risk of binge eating… Another study found that normal weight girls who dieted in ninth grade were three times more likely to be overweight in 12th grade compared with non-dieters.”

In addition to dieting as a cause, “weight talk”—no matter how well-intentioned—and “weight teasing” can lead to EDs and obesity. “Weight talk, or comments made by family members about their own weight or to the child to encourage weight loss, has been linked to both overweight and EDs. Teasing children about their weight also has been associated with the development of overweight, binge eating and extreme weight-control behaviors in girls and overweight status in boys. Body dissatisfaction is a known risk factor for both obesity and EDs.”

So, how does a parent help a child be satisfied with her or his body? How do you encourage your teen toward a healthy relationship with food? “Adolescents who are more satisfied with their bodies report parental and peer attitudes that encourage healthful eating and exercise to be fit, rather than dieting.”

The article contains recommendations for pediatricians, and that guidance also applies to parents:

“Discourage dieting, skipping of meals or use of diet pills to lose weight. The focus should be on a healthy lifestyle rather than on weight.
Encourage more frequent family meals, which provide an opportunity to model healthy food choices and provide time for teenagers and parents to interact.
Promote a positive body image among adolescents. Body dissatisfaction should not be used as a reason to lose weight.
Encourage families not to talk about weight but rather to talk about healthy eating and being active to stay healthy.
Carefully monitor weight loss in an adolescent who is obese or overweight to ensure the teen does not develop the medical complications of semi-starvation.”

Don’t forget family meals. Though your children and teens may roll their eyes, the time spent together around the table is a time to connect over healthy food and discussions about topics great and small. Turn off the television and cell phones (including yours!) and enjoy each other’s company. It will make all of you healthier.

Drugs and young brains

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According to the American Academy of Pediatrics (AAP), one in four young people (ages 12-17) who uses illicit drugs will also develop a dependency. This is a much higher rate than that for adults.

Why? No one is certain, but there are some known factors.

Heredity is one of those factors. Is there an addict or alcoholic (recovering or otherwise) in your family’s history? If so, be aware that this one factor can greatly increase your child’s chances of developing an addiction to drugs or alcohol. You should talk to your teen about this with the hoped-for effect that she will choose to be more careful.

Here are some other factors listed in an AAP web article:

“Untreated psychological conditions such as depression, anxiety, conduct disorder, oppositional defiant disorder and personality disorder. For these youngsters, as well as for those with untreated attention deficit hyperactivity disorder (ADHD) and other learning problems that interfere with academic and social success, taking illicit drugs may be their way of self-medicating.
Temperament: thrill-seeking behavior, inability to delay gratification and so forth.
An eating disorder.
Associating with known drug users.
Lack of parental supervision and setting of consistent limits.
Living in a family where substance abuse is accepted.
Living in a home scarred by recurrent conflicts, verbal abuse and physical abuse.”

Start the conversation about drugs and alcohol early on, in age-appropriate ways. And don’t assume that just because you’ve had this talk once, that’s good enough. Young people are confronted with opportunities on a regular basis, so make sure that you leave the door open to talking with you about it.

Not sure how to begin? Here’s another great AAP article entitled “Talking to Teens about Drugs and Alcohol.” It gives great advice about a conversation that is essential to your child’s health.

Educate yourself about drugs and alcohol. Have open conversation. Don’t abuse substances. Help your teen stay healthy and free from addiction.

Sun(ouch)burn

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Everyone now knows how important it is to limit sun exposure, especially in children. Being exposed to the sun’s rays can lead to skin damage and skin cancer later in life. It’s very important, then, to use sunscreen and to cover up while in the sun, and to limit exposure when possible.

Even so, just about every child will get sunburned at some point, and experience pain, blisters, or worse. When that happens, what should you do?

According to this article from the American Academy of Pediatrics (AAP):

“The signs of sunburn usually appear six to twelve hours after exposure, with the greatest discomfort during the first twenty- four hours. If your child’s burn is just red, warm, and painful, you can treat it yourself. Apply cool compresses to the burned areas or bathe the child in cool water. You also can give acetaminophen to help relieve the pain. (Check the package for appropriate dosage for her age and weight.)

“If the sunburn causes blisters, fever, chills, headache, or a general feeling of illness, call your pediatrician. Severe sunburn must be treated like any other serious burn, and if it’s very extensive, hospitalization sometimes is required. In addition, the blisters can become infected, requiring treatment with antibiotics. Sometimes extensive or severe sunburn also can lead to dehydration and, in some cases, fainting (heatstroke). Such cases need to be examined by your pediatrician or the nearest emergency facility.”

In our office we sometimes get requests for Silvadene (silver sulfadiazine) for sunburn or other burns, but we no longer use that topical medication. There are other products that are better, more effective, and easier to use at home.

Burns of any kind are no fun. Protect your child from the sun when possible. Use the AAP’s advice above when there’s a sunburn, and contact our office if necessary.